| NPI | 1528018975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 2845) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MN 2780) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2007-07-08 |